Dear Expectant mothers, as you approach the third trimester, you are entering the final stretch of this incredible journey. By now, your baby is almost fully formed and finds delightful ways to connect with you—those tiny kicks, nudges, and hiccups are magical, aren’t they? However, pregnancy can sometimes bring unexpected challenges, and one rare but serious condition is acute fatty liver of pregnancy (AFLP) which requires immediate attention.

If left untreated, it can lead to fatal consequences for both mother and baby. Always remember, being aware of the condition is the first step for timely action.

Check out this blog to understand AFLP, its symptoms in detail, and how to manage it effectively.

What is Acute Fatty Liver Of Pregnancy (AFLP)?

Acute Fatty Liver of Pregnancy (AFLP) is a rare and poorly understood pregnancy disorder that typically occurs during the third trimester. At this stage, your body is working tirelessly to support both your health and your baby’s development. However, in rare instances, elevated fatty acid levels can accumulate in the liver cells, causing damage and leading to this serious condition.

Prevalence of Acute Fatty Liver Of Pregnancy (AFLP)

Acute Fatty Liver of Pregnancy (AFLP) is a rare yet serious condition, occurring in approximately 1 in 7,000 to 16,000 pregnancies. It is observed in women experiencing their first pregnancy (primigravidas). The significant physiological and hormonal changes occurring for the first time in their bodies may increase their susceptibility to such conditions.

Recognizing The Symptoms Of AFLP

During pregnancy, every woman experiences a unique set of symptoms. However, in Acute Fatty Liver of Pregnancy (AFLP), these symptoms can closely mimic typical pregnancy discomforts, but often more severe. Thus requiring urgent attention.

• Nausea and vomiting

• Abdominal pain

• Malaise (general discomfort)

• Headache

• Tiredness

• Confusion

• Jaundice

These symptoms can easily be mistaken as pregnancy symptoms. It is important to consult your healthcare provider promptly for an accurate diagnosis.

Risk Factors Associated With AFLP

Acute fatty liver of pregnancy (AFLP) can be influenced by various factors. One of the primary causes is the increased production of fatty acids to support the growth of the fetus and placenta. However, in cases of LCHAD deficiency, the fetus is unable to properly metabolize these fatty acids, leading to their accumulation, which can result in AFLP.

In addition to LCHAD deficiency, other factors may contribute to the development of AFLP, including:

• Multiple gestations

• Carrying a male fetus

• Conditions such as HELLP syndrome and pre-eclampsia, which can complicate pregnancy and increase the likelihood of developing AFLP.

According to the National Library of Medicine, in recent years, there has been a decline in the maternal deaths by 4% due to immediate diagnosis followed by immediate delivery.

How is AFLP Diagnosed During Pregnancy?

AFLP (Acute Fatty Liver of Pregnancy) is diagnosed through a liver biopsy, where a sample of liver tissue is examined under a microscope. However, this procedure is not considered a safe option for pregnant women due to the potential risks involved. Instead, healthcare providers generally diagnose by evaluating the symptoms along with other blood tests. These tests can raise red flags, including:

• Elevated liver enzyme levels

• Blood clotting issues

• Increased levels of ammonia, uric acid, and protein in the blood

• Low blood sugar levels

• Signs of kidney damage

These indicators help healthcare providers assess the condition without the need for a biopsy, ensuring safer management of pregnancy.

Final Thoughts

Though AFLP is a rare condition, the associated risk factors and symptoms can raise concerns for pregnant women. It becomes crucial to monitor and recognize these symptoms in a timely manner to ensure the safety of both the mother and the baby. Early detection and prompt medical intervention are essential for managing the condition effectively. Blood tests assess liver function and identify potential complications and can often eliminate the need for invasive procedures.If you're experiencing any symptoms of AFLP or have concerns about your liver function during pregnancy, consult your doctor immediately.

Frequently asked question (FAQ)

1. What Happens to the Fetus in Acute Fatty Liver of Pregnancy (AFLP)?

AFLP can pose serious risks to the fetus, including preterm delivery, growth restrictions, or stillbirth. Early diagnosis and immediate delivery by caesarean section are important to safeguard the baby’s health.

2. How is Acute Fatty Liver of Pregnancy Different from HELLP Syndrome?

Although acute fatty liver of pregnancy and HELLP syndrome affect the liver during pregnancy, they are two different conditions.

3. Is it Normal to Have Fatty Liver in Pregnancy?

Mild fatty liver changes can occur, but AFLP is a rare and serious condition requiring immediate medical attention. Persistent symptoms like jaundice or abdominal pain should be reported to your doctor.

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